HCP co-investigators, Joseph Newhouse, PhD, Mike Chernew, PhD, Mary Beth Landrum, PhD, and John Hsu, MD, MBA, were recently awarded a new R01 grant by the National Cancer Institute. The title of the grant is called, â€śScreening for Free: A Value-based Insurance Design Natural.â€ťÂ For more information on the project and its goals, please read the abstract:
Aligning health insurance benefits with clinical goals, also known as value-based insurance design (VBID), holds much promise for reducing financial barriers to recommended care, improving quality, and modulating spending growth. While studies have found that patient cost-sharing can reduce the use of necessary care and increase spending for downstream care such as hospitalizations, there have been few rigorous VBID studies, especially of the effects on overall clinical or spending outcomes. The Patient Protection and Affordable Care Act (ACA) requires that all Medicare beneficiaries have free access to preventive services starting in 2011. This elimination of cost-sharing has the potential to mitigate underuse of cancer screening tests recommended by the US Preventive Services Task Force (USPSF). Using information from large Medicare Advantage plans, this project will examine the clinical and economic effects of this ACA-mandated Medicare policy change on screening test rates, clinical event rates, and total medical spending. We will evaluate the outcomes in all subjects and illustrative subgroups, e.g., subjects for whom screening may be of high or low value as indicated by the USPSTF recommendations. This study will provide an opportunity to evaluate the largest VBID natural experiment to date, to examine the early effects of a major ACA provision on access to preventive care, and to inform future Medicare policy decisions.